On April 25, Uganda celebrated World Malaria Day. The ministry of Health reminded us about our responsibility in preventing and managing malaria especially during the Covid-19 pandemic with an important reminder on their social media channels:
“Why survive Covid-19 and die of malaria?” It may seem like a simple rhetorical question, but there are structural and systemic challenges that need to be addressed to ensure that we continue providing communities with essential life- saving health services whilst we work to combat Covid-19.
The Covid-19 pandemic and the various measures such as travel restrictions enacted to curb its spread – though well-intentioned – pose a multiplicity of health-related challenges.
Several studies have demonstrated that utilization of health services is affected by the inability of users to reach health service delivery points, especially when not within walking distance. Thus far, anecdotal reports suggest that restrictions on the use of public and private transport have negatively impacted utilization of health services for some Ugandans.
For instance, people with chronic diseases that require continuous care have been affected due to challenges getting prescription refills from their providers. Preventive and promotive health services like immunization, antenatal care and family planning have also been affected.
Therefore, interventions like the provision of ambulances to facilitate transport and toll-free lines that citizens can call to request health facility transport are welcome.
To ensure the continuity of essential health services at community and facility levels, we have to ascertain that services are available, inform the public about them, eliminate any barriers to their access, and ensure health workers can reach their duty stations in a safe and timely manner.
At the community level, Village Health Teams (VHTs) should also be supported to access the ministry of Health’s new guidelines to ensure they understand their role in supporting the Covid-19 response and continuing to provide basic health services—especially in rural areas where access is more challenging.
The ease of transmission of Covid-19 has brought focus on the importance of infection prevention in health care settings and the need for personal protective equipment (PPE) for health workers, including VHTs. When health workers are not protected using appropriate PPE, their ability to provide service is curtailed. Furthermore, the risk is transmitting infections to their clients also increases.
”We can’t stop Covid-19 without protecting health workers first,” said WHO director-general Dr Tedros Adhanom Ghebreyesus.
Lessons from past large-scale outbreaks underscore this delicate relationship between access to health services and the safety concerns of health workers and healthcare consumers.
As such, the government and health implementing partners should focus on strengthening our health system at all levels to continue providing essential health services as well as effectively managing the potential burden of Covid-19 cases.
Demand-side barriers such as uncertainty about service availability, lack of transport and fear of health facilities should be addressed, as should the supply-side barriers like non-availability of services and lack of PPE for community and health facility workers.
There shouldn’t be any de-prioritization of essential health service delivery whatsoever.